Provider Demographics
NPI:1528463171
Name:WEBB, SHERRY
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:152 MAIN STREET
Mailing Address - City:CLOVERDALE
Mailing Address - State:OH
Mailing Address - Zip Code:45827-0086
Mailing Address - Country:US
Mailing Address - Phone:419-488-2310
Mailing Address - Fax:419-488-2330
Practice Address - Street 1:152 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CLOVERDALE
Practice Address - State:OH
Practice Address - Zip Code:45827-0086
Practice Address - Country:US
Practice Address - Phone:419-488-2310
Practice Address - Fax:419-488-2330
Is Sole Proprietor?:No
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator